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Institute evolves into new profit center for health care system. Services were dictated by demand from institutions across the country. Before visit, attendees asked to identify their areas of greatest concern.
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OBJECTIVE: The objective is to provide insight to understanding public health officials' needs and promote access to data repositories and communication tools. METHODS: Survey questions were identified by a focus group with members drawn from the fields of librarianship, public health, and informatics. The resulting comprehensive information needs survey, organized in five distinct broad categories, was distributed to 775 Tennessee public health workers from ninety-five counties in 1999 as part of the National Library of Medicine-funded Partners in Information Access contract. RESULTS: The assessment pooled responses from 571 public health workers (73% return rate) representing seventy-two of ninety-five counties (53.4% urban and 46.6% rural) about their information-seeking behaviors, frequency of resources used, computer skills, and level of Internet access. Sixty-four percent of urban and 43% of rural respondents had email access at work and more than 50% of both urban and rural respondents had email at home (N = 289). Approximately 70% of urban and 78% of rural public health officials never or seldom used or needed the Centers for Disease Control (CDC) Website. Frequency data pooled from eleven job categories representing a subgroup of 232 health care professionals showed 72% never or seldom used or needed MEDLINE. Electronic resources used daily or weekly were email, Internet search engines, internal databases and mailing lists, and the Tennessee Department of Health Website. CONCLUSIONS: While, due to the small sample size, data cannot be generalized to the larger population, a clear trend of significant barriers to computer and Internet access can be identified across the public health community. This contributes to an overall limited use of existing electronic resources that inhibits evidence-based practice.
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Transferred patients have 38% longer ICU stays and 41% longer hospital stays. Many databases used for report cards are administrative, not clinical. Active awards are seen as more valid than passive ones.
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The objective of this study was to measure the consistency of coded medical data through information managers' reports of the overall coding error level in patients' medical records. Using a cross-sectional design, we examined the reported percent of records containing coding errors significant enough to change a diagnostic related group (DRG). Results indicate about 87 percent, 9 percent, and 5 percent of respondents reported that significant coding errors existed in less than 5 percent, 6-10 percent, and greater than 10 percent of the medical records in their institutions, respectively. Significant variation was found in the accuracy and consistency of coding practice and associated data quality across key demographic and organizational variables. Significantly large error rates in coded data exist in some organizations. Given variations across key demographic characteristics, providers may tend to distrust all coded data, when aggregated. As the United States moves toward an evidence-based medicine environment, the use of current patient data classification methods may be of limited value without increased attention to coding practices.
The energy demand of municipal wastewater treatment plants for nutrient removal equipped with primary clarifiers, activated sludge system, anaerobic sludge digestion, and CHP is evaluated theoretically, on the basis of COD balances. Operational experience from energy-efficient Austrian treatment plants confirms that the demand on external electrical energy can be kept as low as 5 to 10 kWh/(pe.a) depending on the N:COD ratio in the raw wastewater. A low N:COD ratio helps to keep not only the effluent nitrogen load low, but also the energy demand. Measures to minimise the energy demand at treatment plants and to reduce the nitrogen load are discussed.
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